Abstract
Supplementation with nicotinamide adenine dinucleotide (NAD+) precursors including dietary nicotinamide has been found to boost tissue NAD+ levels and ameliorate oxidative stress-induced damage that contributes to aging and aging-related diseases. The association between dietary NAD+ precursors and patient-reported health-related outcomes in cancer survivors has not been investigated. This study aimed to determine associations of dietary nicotinamide intake with different patient-reported outcomes in colorectal cancer survivors, 2 to 10 years post-diagnosis. A total of 145 eligible participants were recruited into this cross-sectional study. Dietary nicotinamide intake level was calculated based on data from 7-day food diaries. Fatigue was assessed with the Checklist Individual Strength (CIS), which is a subscale of the cancer-specific European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC), and anxiety and depression were assessed with Hospital Anxiety and Depression Scale (HADS). Oxidative stress marker serum protein carbonyl contents and serum NAD+ levels were measured. A hierarchical linear regression model with confounder adjustment was performed to analyze the association of nicotinamide intake, serum protein carbonyl contents, and NAD+ levels with patient-reported outcomes. The median values of daily nicotinamide intake for male and female participants were 19.1 and 14.4 mg, respectively. Daily dietary nicotinamide intake was associated with a lower level of fatigue (β: −14.85 (−28.14, −1.56)) and a lower level of anxiety and depression (β: −4.69 (−8.55, −0.83)). Subgroup analyses by sex showed that a beneficial association between nicotinamide intake and patient-reported outcomes was mainly found in men. To conclude, our findings suggested that higher dietary NAD+ precursor nicotinamide intake was cross-sectionally associated with less patient-reported outcomes in CRC survivors.
Highlights
Colorectal cancer (CRC) is the third-most common cancer worldwide in men and women combined [1]
Our findings indicate that a higher intake of nicotinamide, the main dietary NAD+ precursor, was significantly associated with lower levels of self-reported fatigue and anxiety in CRC survivors 2–10 years post-diagnosis in analyses adjusted for age, sex, BMI, daily average energy, number of comorbidities, received chemotherapy, hours of per week MVPA, years since diagnosis, and supplement usage
Due to comorbidities or advanced age, some older adults may not have the required strength for intensive exercise, which may restrict the practical application of such interventions among CRC survivors
Summary
Colorectal cancer (CRC) is the third-most common cancer worldwide in men and women combined [1]. The incidence of CRC is expected to rise up to 2.2 million new cases per year by 2030 [2]. Increased aging of the population, unfavorable dietary habits, and specific risk factors (e.g., overweight, physical inactivity and sedentary behavior, alcohol consumption, smoking, and comorbidities such as inflammatory bowel disease and type II diabetes mellitus) have been reported to account for this trend in CRC incidence [3]. Early detection and improved treatments have improved the CRC survival rates in recent decades [4]. CRC survivors often report various complaints or adverse effects after treatment, such as fatigue, pain, impaired sleep, and mental problems, which may affect health-related quality of life (HRQoL) [5]. Identifying targets and factors for interventions to promote better HRQoL of CRC survivors is warranted
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